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Mental/Behavioral Health

How a Maine family lost a loved one to homelessness and mental illness

Bangor Daily News - 3/20/2017

March 20--By the time Elizabeth Chase-Cosby disappeared five years ago after being discharged from a Bangor psychiatric center, her younger sister, Kate Tuck, already knew she was suffering from mental illness. Their relationship, once very close, had been strained for years by the bizarre behaviors and unpredictable outbursts that had increasingly characterized her interactions with her older sister, who had previously been living in an off-grid camper in Plymouth.

Still, Tuck, 55, was unprepared for the shocking news late last month that Chase-Cosby had died, homeless and alone, in a public park halfway across the country in the city of Grand Island, Nebraska. Tuck has no idea why her sister was in Nebraska or how she got there. She didn't know her sister was homeless either. She was 58 years old and left behind three grown children and a five-year-old grandson she had never met.

"We were so close," Tuck said, her eyes welling, "and we raised our children together." Brought up in New Hampshire along with their younger brother by parents who divorced when the children were young, Tuck now lives in Bangor and works two jobs, one as the manager of the Filibuster Lounge at the Best Western White House Inn in Hermon and the other as a direct care provider and art instructor for Amicus, a nonprofit agency that serves adults with intellectual disabilities.

Her sister's progression into mental illness and homelessness has not only grieved her heart; it has made her more aware of the need for services that support homeless adults, many of whom suffer from mental illness. If Betsy, as her sister was called, had had better access to health care, counseling and other supports, Tuck said, her story might not have ended so sadly.

Signs of trouble

The early signs of Chase-Cosby's illness may have been masked by a lifelong tendency to deep emotional swings, a flair for personal drama, an early attraction to psychedelic drugs, a lifestyle marked by unstable relationships, a series of short-term jobs and frequent relocations, Tuck said. But things began to escalate the early 1980s, when the two were in their 20s.

"That's about the time the episodes started happening," she said.

One time, she recalled, she and a friend found Chase-Cosby hitchhiking alone.

"We stopped and got her into the van and she was rambling, talking in numbers, totally incoherent. I thought she had taken some bad acid," she said. They drove straight to the nearest hospital emergency department, where her sister was diagnosed with Graves' disease, a hyperthyroid condition that can sometimes trigger agitation, anxiety and psychosis.

But it's unclear that Graves' disease was the real culprit. Tuck said her sister had several full-blown psychotic episodes over time and was prescribed various medications to manage her symptoms. The medications would help for a while, but Chase-Cosby would invariably stop taking them, first complaining of unpleasant side effects and then developing a conviction that the drugs were an attempt to kill her.

Eventually, Chase-Cosby moved to Lewiston for a job, leaving her school-age daughter, Jasmine, in her sister's care. Tuck's daughter Sarah was the same age. "We were pregnant together," Tuck said. "I had my Sarah and she had Jasmine. They were inseparable as babies." It was easy to bring her niece into her home.

"I basically raised Jasmine right through high school," Tuck said. Jasmine graduated from college, joined the Army National Guard, married and now has a five-year-old son. Calls to her seeking comment for this story were not returned.

Losing touch, losing track

Tuck made several trips to Lewiston during those years to check on her sister's wellbeing. By then, Chase-Cosby had a second daughter, who Tuck sometimes brought back to her home until her sister was stable again. That daughter now lives in Texas, Tuck said. A son, the eldest child, was placed in an adoptive home at birth and had recently made contact with his birth mother. Tuck did not know the details of that interaction.

Sarah, now 34, said she and her Aunt Betsy became close after she and her cousin Jasmine grew up and moved out on their own. By then, Chase-Cosby had moved to Virginia and then back to Maine and was living alone in a camper, without electricity or running water, on land she had purchased years before in Plymouth. Chase-Cosby would sometimes visit her at home in Dixmont to share a meal, enjoy the shower and wash her clothes.

"When she was on her meds, she was fine," Sarah Tuck said. "But then she would go off her meds and have these bad spells." Sometimes, for example, her aunt would "talk to angels," she said. As the bad spells grew more frequent, the two drifted apart.

She last saw her aunt in January of 2012, when she was contacted by police concerned for Chase-Cosby's welfare. When she arrived at the camper, she found Chase-Cosby "sitting in the snow, in the cold, not making any sense."

An ambulance arrived and transported her aunt to the Dorothea Dix Psychiatric Center in Bangor.

"That's the last time I saw her," she said. It's unclear whether Elizabeth ever returned to the camper.

Sarah Tuck has occasionally searched her aunt's name online. She found that she had been arrested for theft in Iowa and had registered to vote in Colorado. "So I knew she was doing okay," she said, but there had been no opportunity to trace her whereabouts.

Then, on the evening of February 27, a police officer came to her home and told her the news. Elizabeth Chase-Cosby's body had been found by passersby in Memorial Park in Grand Island, Nebraska, a city of 50,000 about 100 miles west of the capital city of Lincoln. She had died of exposure.

Sarah Tunk thinks her aunt must have had some kind of next-of-kin information amid her belongings that enabled officials to find her.

"It was heartbreaking," she said. "I kept expecting her to just walk up the driveway someday. ... I would have dropped everything and flown out there to bring her home if I had known."

The kindness of strangers amid dwindling resources

In Grand Island, funeral director Dan Naranjo of All Faiths Funeral Home said Chase-Cosby had been in town for a couple of months before she died.

"So many people here tried to help her, but she was very guarded," he said. She repeatedly refused to go to the public shelter for women and children, where she would have been offered not only food and shelter but also counseling and help to find permanent housing or connect with kin.

As an alternative, agencies had several times paid for a motel room and let her know it was available, thinking it might better suit her independent streak, but she never accepted, Naranjo said. Others, including private citizens, brought her food, which she usually refused.

Naranjo said the small city is "not immune to homelessness." In Chase-Cosby's memory, he hosted a community prayer service on March 8, for all who wished to attend.

"I feel we are all God's children," he said. "We need to honor Elizabeth's life and to be reminded of others like her who walk in her shoes."

Boyd Kronholm, executive director of the Bangor Area Homeless Shelter, said the majority of homeless people in this community suffer from mental illness, substance abuse or physical disabilities. It's not unusual for this population to refuse services, including health care, he said.

But even for those who are willing to accept interventions such as case management, counseling, housing and medication management, there's no guarantee those services will be available. Increasingly restrictive regulations mean fewer and fewer adults in Maine, including the homeless, qualify for MaineCare, the state's Medicaid program for low-income and disabled residents, which pays for such services, Kronholm said.

That leaves fewer opportunities for social agencies to lend a helping hand in getting the homeless off the street and into less vulnerable situations. It's a growing and unfortunate trend in many states, Kronholm said, and a contributing factor in too many sad stories.

Kate Tunk is deeply grateful to the strangers in Grand Island who tried to help her sister. And she wants them to know that she was not alone in the world, that she had people who loved her, land she owned and place to call home if she chose to.

"Betsy was not without family or means and she had a great spirit and love for her family and children," she wrote in a letter to be read at the prayer service. "Had she had proper medication for her chemical imbalance, Betsy would not have died alone in a park, ALONE! so far away from us."

Elizabeth Chase-Cosby's ashes will be sent home next week to her family in Maine.